Healthy Hormones

Is a Low TSH Level Dangerous?

Is it dangerous to have a suppressed TSH level lower than the "normal" range?

Does a low TSH increase the risk for osteoporosis or heart problems?

Are there situations when having a suppressed TSH is not only safe but helpful?

Are there things that can be done to avoid the potential negative side effects of a low TSH?

I will try to answer these questions and others in this article...


What is TSH?

Let's have a quick reminder of what exactly the TSH is and what it indicates.

TSH is short for Thyroid Stimulating Hormone.  This hormone is produced by the pituitary gland in the brain.  It's purpose is to stimulate the thyroid gland to produce thyroid hormone.

The pituitary gland measures the level of T4 and T3 in the blood of the pituitary and secretes TSH in order to keep the levels of thyroid hormone in the optimal ranges.

When the body is healthy and working normally, this feedback loop works seamlessly to regulate thyroid function in the body.

As a reminder, if there are low levels of T4 and T3 in the pituitary gland, it will increase TSH secretion to try to stimulate the thyroid to produce more thyroid hormone, so the TSH level will rise.  Conversely, if there is an excess of T4 or T3, the pituitary will decrease TSH production.  The TSH level will drop or sometimes even go to zero.

The result is the TSH moves in the opposite direction of the thyroid hormone level.  If you are low in thyroid hormone, your TSH will usually go high, and vice versa.

What is a Normal TSH Level?

When looking at a characteristic found in a large population of people, the results will follow a predictable distribution across a graph.  

For example, if you graph the heights of everyone in the world, the results will range from as little as 21.5 inches to as tall as 97 inches with the average being about 68 inches.  The majority of people in the world will be close to the average height.  The further away from the average you go, the fewer people will be that height.

The result is what is commonly called a Bell Curve:

This is also how reference ranges for lab tests are determined.

However, a Bell Curve also assumes that all people included in the graph are equivalent - meaning none are on medication, have different diets, genetic history, etc. which could affect the results.

ZRT is a well-known national laboratory.  Their website explains it like this:

Reference ranges do not always reflect a “normal” healthy population free of medications. Most laboratories establish their reference ranges from a large population of people where detailed information on health status, stage of life (premenopausal vs. postmenopausal), and medications and hormones used is unknown, and therefore not taken into account. Couple this with differences in lifestyles, physiology, dietary habits, and genetic heredity, and it’s even more difficult to define, let alone find, a normal population.  

This is what happened when the "normal" reference range for TSH was first established.  It has since been determined that up to 30% of the people who have a TSH > 3.0 have undiagnosed autoimmune thyroid disease, which skews the TSH results higher than what they would be in a population with no thyroid issues.

So instead of a normal range of TSH ranging from about 0.4-5.0 which it is for most labs, it should instead be about 0.4-2.0.

In other words, even if a patient's TSH comes back at something like 3.5, even before I look at the other lab tests, that signals to me that there is most likely some degree of thyroid dysfunction in that person.

Is a Low TSH Level Dangerous?

The TSH is an indicator of blood levels of T4 and T3 in the pituitary, which may not be the same as in the rest of the body.  This is because the pituitary has a different deoidinase enzyme than the rest of the body.

In this article, I discussed why I believe that the free T3 and reverse T3 levels are much better indicators of thyroid activity at the cellular level than is the TSH.

I recommend trying to get the free T3 > 3.5 and the reverse T3 < 15 if possible.  In my experience, that is sometimes very difficult to do in many patients without suppressing the TSH to < 0.4.

So is lowering the TSH < 0.4 dangerous?  What if the patient has none of the symptoms of an overactive thyroid (thyrotoxicosis) such as palpitations, tachycardia, insomnia, anxiety, etc.?

What if the free T4 and free T3 levels are in the optimal range even if the TSH is suppressed?  Is the low TSH a concern?

The majority of concern about the dangers of lowering the TSH come from studying patients with Grave's Disease.  Grave's is an autoimmune disease which results in the overproduction of thyroid hormone which results in a suppressed TSH.

Grave's disease has been shown to result in an elevated serum calcium level due to excessive bone turnover.  Untreated, this could ultimately result in significant bone loss and osteoporosis.

Another study, however, showed that in order to get the free T4 level in the optimal range in patients with hypothyroidism, it required them to take a dose of levothyroxine that resulted in a TSH level suppressed below the reference range in over 48% of the patients.

Potential Side Effects of a Suppressed TSH Level

There are actually 2 different instances where suppressing the TSH is not only acceptable but considered the standard of care in conventional medicine:

  • After thyroidectomy in thyroid cancer patients
  • In patients with thyroid nodules

Both of those groups are good to study to see if any dangerous side effects occurred with long term TSH suppression.

So what does the literature say?  Does lowering the TSH with thyroid medication result in the same potentially dangerous side effects that Grave's disease can cause?

Let's look at it further...

Bone Loss

In this study, there was no significant bone loss in thyroid cancer patients treated with suppressive doses of thyroid hormone.

This study showed no decrease in bone mass after 1 year in patients receiving suppressive doses of thyroid hormone for treatment of thyroid nodules.

However, this meta-analysis did show a reduction in bone mass in postmenopausal women who received suppressive doses of thyroid hormone for over 9 years.  Of note, it did not show the same result in premenopausal women.  But this study did not show an increase in bone loss in women with low TSH levels.

This study also showed an increased risk of hip and vertebral fractures in women over age 65 that had a TSH of 0.1.  But this study showed there was no increase in fracture risk in women < age 65.

In this study, any bone loss associated with prolonged use of thyroid hormone therapy was prevented by the use of estrogen replacement.  The use of calcium has also been shown to negate any bone loss caused by thyroid hormone.

Bottom Line?  Prolonged suppression of the TSH for years may cause bone loss in postmenopausal women.  The amount of bone loss appears to depend on how long they TSH is suppressed and how much it is suppressed.  The risk seems to be minimal in premenopausal women.  

It also appears that the bone loss can be prevented by using bioidentical hormone replacement and nutrients such as calcium and vitamin D.

So what if the only way you can get your free T3 and free T4 levels to the optimal range is by lowering your TSH < 0.4?  

First of all, you need to discuss the pros and cons with your doctor before a decision is made.  If you decide to take suppressive doses of thyroid hormone, then the bone loss risk can probably be minimized by also taking bioidentical estrogen, calcium, and vitamin D.  

Cardiac Issues

Thyroid hormone definitely has an impact on cardiac function.  It helps regulate heart rate, the size of the heart, and the pressure inside the chambers of the heart.

Conditions such as Grave's Disease that cause large increases in thyroid hormone levels have been shown to increase the risk for things such as atrial fibrillation, heart enlargement and heart failure.

So the question becomes, does taking excessive amounts of thyroid hormone result in the same risks as Grave's Disease?  At this point, there is not enough data to say yes or no.

So how does thyroid hormone affect the heart?

The heart appears to only respond to T3, yet it is unable to convert T4 to T3 in the cardiac tissues

It therefore only makes sense that thyroid medications that contain T3 (Cytomel, liothyronine, natural dessicated thyroid) may have more of a cardiac effect than thyroid medications that only contain T4 (Synthroid. Tyrosint, levothyroxine).

If someone has a very healthy T4 to T3 conversion system, they may still get cardiac symptoms from a T4 only medication, but many people have a defect in that conversion.

The risk of excessive thyroid hormone on the heart appears to depend on both how long the TSH is suppressed and how much it is suppressed.

For example, people with a slightly suppressed TSH (subclinical hyperthyroidism) have only mild cardiac issues when compared to Grave's patients.

Fortunately, studies also show that the cardiac abnormalities return to normal once the thyroid level in the body is normalized.

There is also evidence that using beta blockers can prevent and reverse the cardiac changes seen in hyperthyroidism.

Bottom Line?  Based on the studies, it appears that suppressing the TSH temporarily will not lead to long term cardiac complications.

Also, if you are taking suppressive doses of thyroid hormone, taking a beta blocker at the same time may actually prevent any cardiac complications from occurring.

There may therefore be situations where taking suppressive doses of thyroid medication for a short time may be beneficial with minimal risk.  However, it should only be considered after consulting with a doctor with experience in thyroid management.

Should We Even Monitor the TSH?

I had a patient ask me recently, "If the TSH is not an accurate measure of thyroid levels in the cells of the body, why even check it?"  

That is a fair question, but the fact is, monitoring the TSH is still considered standard of care for managing the thyroid.  The TSH should therefore be monitored, just not by itself.  

The whole picture of the thyroid should be evaluated by monitoring the complete thyroid panel which also includes the free T4, free T3, reverse T3, and thyroid antibody levels.

If your doctor is not checking all of these labs when testing or monitoring your thyroid function, you are not getting a complete picture of what is going on with your thyroid.

Read this article if you want to know more about each of these lab tests, what they mean, and optimal ranges of each.


It is important to monitor your TSH level as part of your thyroid hormone management, but it is even more important to monitor all of the tests in a complete thyroid panel.

Taking enough thyroid hormone to lower your TSH level below the normal reference range may have some potential long term consequences.  Fortunately, most of those can be avoided if your thyroid levels are closely monitored and managed properly.

It may require taking suppressive doses of thyroid hormone temporarily in some patients in order to get their free T4 and free T3 levels into the optimal ranges.  In those instances, it is extremely important to monitor bone density and cardiac health.

In many cases, the bone loss may be prevented by also taking bio-identical estrogen and calcium.

Many of the cardiac issues may be prevented by also taking a beta-blocker.

As a general rule, taking enough thyroid hormone to suppress the TSH should be avoided in postmenopausal women, whereas the risk does not appear to be as high in premenopausal women and in men.

Now it's your turn...

Have you even taking enough thyroid hormone to suppress your TSH?

Did you have any negative side effects?

Do you currently have a TSH in the normal range, yet you still have symptoms of low thyroid?

Leave your questions or comments below.

About the Author Dr. Jeff Whelchel

Dr. Whelchel is a family physician who specializes in functional medicine, especially hormone optimization. He has over 20 years experience in private practice managing patients with various medical issues. His passion is helping patients reach their full potential of wellness and quality of life. He grew up in the Texas Panhandle where he currently lives. He is married and has 3 awesome children.

Leave a Comment:

Theresa says June 11, 2018

Hi there I am a post menopausal woman of 63 yrs. and I have been taking 100 mcg of levothryroxine sodium for 24 yrs. my TSH result is 1.14. I just had a HTMA (hair, tissue, mineral analysis) done and it says I have a hypothyroid. I don’t understand why this is since I am on this medication for this. Shouldn’t my thyroid show normal?
Any advice you can give me would be wonderful.
Theresa 647-899-7790

    Dr. Jeff Whelchel says June 11, 2018

    Hello, Theresa. Thanks for reading my blog.

    I really don’t think you can fully evaluate your thyroid level with just a TSH. You also need a free T4, free T3, reverse T3, TPO antibody, and thyroglobulin antibody level. Then you will have a better picture of your thyroid function.

Kl says October 23, 2018

Hi, I have Hashimotos disease for over 10 years and am currently on synthroid. My TSH stopped signaling about 3 years ago after a very stressful event. We tried lowering the dosage and my FT3 and FT4 went below range and the TSH came up slightly but was still below range and I felt dreadful. Are there people who just have no TSH readings? It’s concerning that osteoporosis and heart disease are likely ..

    Dr. Jeff Whelchel says May 11, 2019

    Hi Karen. You need further thyroid evaluation. Your condition could be due to Hashimoto’s, Grave’s disease, or other issues.

Karen Little says November 2, 2018

Hypothyroid was on Levothyroxine years under medicated, eventually they upped meds from 50mgs to 150mg then again to 200mg my TSH was 0.004 ref range 0.3- 5.0 I reduced back down to 150mgs still same 0,004 and then reduce to 100mgs T4 and 20mgs T3 added, this was 2 years ago My TSH has stayed the same, I have a faulty Di02 genetic fault, I still feel hypothyroid and have many days where I have to stay in bed no energy,,, my SHGB was 70 when i was on 200mgs T4 but lowered to 60 when i was on 100mgsT4 and 20mgs T3.. I have recently started getting carpel tunnel, raynauds and have frozen shoulder,,, should I worry about my bones? I had a sub thyroidectomy 35 years ago and diagnosed hypo 2002, and never felt well on T4 mono, I am 70% better with T3 added, but I am concerned seeing this about bones I am 55.. I take Evorel oestrogen patch and have had several steroid shots in frozen shoulder??

    Dr. Jeff Whelchel says May 11, 2019

    Hi Karen. It looks like you have not had a complete thyroid panel drawn, including thyroid antibodies, reverse T3, free T3 and free T4. Just looking at the TSH does not give you a complete picture. You need to sit down with a physician who is comfortable managing thyroid (including NDT and T3 meds). Best of luck.

Matthew says June 13, 2019

After a decade with untreated Hashimoto’s, my thyroid goitered a decade ago. Starting with levothyroxine then mixed with liothyronine because my conversion doesn’t work right, I switched to Armour and titrated up to 300mg. Any attempt at lowering my dose to 240mg gives me hypothyroid symptoms and leaves me bedridden. My <0.02 TSH freaks doctors out, now I can't find a new doctor. TPOab increases rapidly with dose reduction. I asked for a DEXA scan. If my bones are healthy, shouldn't I just continue on suppression therapy for life?
What cardiac issues can be tested, and would I just add a beta blocker for life?
Thank you.

    Dr. Jeff Whelchel says June 14, 2019

    Hi Matthew. As long as your vitamin D is optimal (50-80) and you are doing weight-bearing exercise, your risk of bone loss is minimal in my opinion. If the free T3 and free T4 levels are not high, then you are not hyperthyroid even if your TSH is suppressed.

    If you want your heart checked out just to be sure, I would request a 48 hour holter monitor. The primary potential cardiac risk factor is atrial fibrillation which would be detected on the monitor (if it occurred during that 48 hours of testing).

Cynthia wiedmann says June 25, 2019

Hi doctor, thank you for your informational site. I am 58 year old female. November 2017 thyroid removed due to Papillary Cancer. Rai treatment. Prescribed levothyroxine 125. I am 5’7″ 165lbs. July 2018 I complained of muscle pains and fatigue. Taking 3 naps a day and sleeping 10 hours at night.Was prescribed Liothyronine 5mcg and pains stopped and not fatigued. But my TSH levels have dropped to .009. a year ago my TSH .035… The last time my t4 checked was March 2018 t4 1.56ng/dl…
I have an upcoming appointment with my endocrinologist and am trying to formulate questions for him. Another concern of mine is my heart. I live on a small farm and this year I find I get winded and heart beats fast when doing my regular chores done for years.

    Dr. Jeff Whelchel says July 9, 2019

    Sounds like you could be having some hyperthyroid symptoms. You really need to know what your complete thyroid panel shows. That would include a free T4, free T3, reverse T3, TSH, and thyroid antibodies. That is only way to fully assess your thyroid status. Best of luck.

J. Parry says July 1, 2019

I have Hashimoto’s thyroiditis. Levothyroxine improved my symptoms, but when it seemed as if I was nearing an optimal dose TSH was suppressed (lowest 0.01) and both T3 and T4 within range though quite high.

I had to take a reduction in thyroxine as a result. After more than six months on the reduced dose TSH is within range but hypothyroid symptoms have become worse.

A referral to an endocrinologist was rejected because all my tests were “Normal”!

    Dr. Jeff Whelchel says July 9, 2019

    Sorry to hear of your troubles. In my opinion, the free T4 and free T3 levels are much more accurate at measuring thyroid hormone levels than the TSH. Perhaps there is a happy medium from where you were to where you are now? If your doctor will not consider checking a complete thyroid panel and looking at all of the results, I would suggest looking for another medical provider in your area that will help you. Best of luck.

Bonnie says July 26, 2019

My TSH is undetectable but my T3 and T4 are normal. I’m on Synthroid and Liothyronine. The reverse T3, TPO and thyroglobulin antibody were normal. I’m a 63 year old female. Do I need ti be concerned about the TSH being undetectable…,less than.01. I went on thyroid medication because of symptoms – T3 was low. T4 was not converting to T3.

    Dr. Jeff Whelchel says February 10, 2020

    Long term suppression of TSH is controversial. If your free T3 and free T4 levels are good, then I’m not as concerned. Make sure you are having consistent weight-bearing exercise and that your vitamin D is in the 50-80 range.

Chris says September 8, 2019

Hi DR:
I have a child with Down Sundrome. She’s 26. We had her thyroid tested and it was slightly elevated. He said Mild case of overactive thyroid. The Dr had it run again 3 weeks later and it was slightly lower. The first time he spoke to us about the possibility of a one time radioactive iodine pill that destroys something and makes it underactive. Then he waits 2 months and treats her for underactive for the rest of her life. The next appt I was not able to attend. Her mother took her (who is overly pro meds) . WE have a conservatorship and we both make the4 decisions. In any case apparently the next lab work she was mildly lower. I found out he put her on hormone pill to raise her level. I can’t figure this out. If it was high the first time and low the second time why would he treat her for anything. Wouldn’t he want more tests? I’m confused. This doesn’t seem right? Thank you

    Dr. Jeff Whelchel says February 10, 2020

    It’s really hard to answer your questions without knowing what tests were run and what the results showed. I would strongly suggest getting a printout of her lab results. Have the doctor explain everything. If you still don’t have an understanding or a peace about the treatment plan, I would get a second opinion. Best of luck.

Bren Traxler says January 22, 2020

Hello Dr. Whelchel,
I am a 66 year old female who had Graves disease in 1976 resulting in 75% of my Thyroid gland being removed at that time. I have been on some type of synthetic thyroid hormone replacement since then. I had a TSH test done on October 4, 2019 and it showed a level of .936. My doctor said that was still too high so she wanted to lower the daily dosage of Levothyroxine from .125MG to .112MG. But then I mentioned to her that I had been having a little anxiety and difficulty sleeping so she told me to just quit taking the Levothyroxine. I trusted her and complied with her wishes. I started gaining weight, then started having really bad charlie horses in my calves and severe cramping in my feet. So I returned to her office on January 17, 2020 and requested that she re-check my Thyroid. She agreed to do another TSH test and after extensive google research (which I had never felt the need to do before) I insisted that she do a Thyroid Panel with TSH and she reluctantly agreed. My results were as followed:
TSH – 85.370, Thyroxine (T4) – 1.7, T3 Uptake – 1.6, and Free Throxine Index – 0.3.
So she called in the prescription of Levothyroxine of .112. I began taking this daily dosage on January 20, 2020 (3 days ago). I have continued to gain weight, my neck and shoulders are feeling tight and fatigued, I am continuing to have cramping in my feet, and I feel highly stressed. I am concerned that this could be dangerous for me if I am not returned quickly enough to a more normal Thyroxine range. Could you please comment. I also have put a call back into her and asked her to give me a call back so we can discuss. You seem to have much more knowledge about this subject than I believe my doctor does. During my research, I came across an article about a rather new drug of T3 that can raise the levels more quickly and am wondering if this would be helpful in my case? Thank You in advance for any help you can provide!!

    Dr. Jeff Whelchel says February 10, 2020

    I’m so sorry to hear of your troubles. You still did not get adequate testing done. You are extremely hypothyroid, but you have no information on how your free T3 level is doing.
    I would suggest getting a complete thyroid panel like I suggest in the article – TSH, freeT4, freeT3, reverse T3, TPO ab and thyroglobulin ab. If your doctor doesn’t know how to interpret those results, I strongly suggest finding a different provider. You deserve to feel better. Levothyroxine is often not the best choice of thyroid medication.

Tannauz says February 5, 2020

Hello Dr.
My TSH IS .02. I’m taking t3 and t4 and they are normal now but the TSH remains low. I’m still very exhausted, feel heart palpitations wich Dr.s are dismissing and have continual hair loss.
What are your recommendations? I’m at a loss.Canada’s medical system sucks.Becuase its free , there are so many protocals to not test so the system can save money.There are ashortage of Dr. and th are over worked, underpaid and poorly educated.

    Dr. Jeff Whelchel says February 10, 2020

    Hello. I would need the numbers of the complete thyroid panel – free T3, free T4, reverse T3, thyroid antibodies to truly answer your question. If you don’t have those, I would go back to the doctor that is managing your thyroid. Good luck!

Emilie Friesen says March 29, 2020

I am a 78 yr old woman who recently tested 0.04 on TSH test. I have ALL the symptoms of hypothyroid condition including frequent cramping in legs and feet, with severe sleeping problems, anxiety and mood swings. I have been on Synthroid for years taking 75 mcg lowered recently to 50 mcg. I also have Sjogrens disease causing dry brittle hair, dry skin, mouth, eyes, swollen painful joints. Should I be on Synthroid?

    Dr. Jeff Whelchel says April 1, 2020

    Hi Emilie. You need to get a complete thyroid panel drawn. That includes a TSH, free T4, free T3, reverse T3, TPO antibodies and thyroglobulin antibodies. Just having a TSH is not enough information to answer your question. Hopefully your medical provider will help.

Carla says April 29, 2020

So I had a total thyroid surgery in 2007. I am currently on armour 300mg. My lastest test shows tsh .32, t4 .9, and t3 is 6.3. they are wanting to lower my dose is that wise. I feel fine on what I am even those I have never been able to lose weight. My hair and nails are fine.
Thank you for your time.

    Dr. Jeff Whelchel says April 30, 2020

    Did you take your thyroid medication the morning of your labwork? The T3 level will be falsely high if you did. I would ask to have it rechecked and this time don’t take it that morning. If you did take it, they your level is too high. I like it around 3.5-4. Good luck.

Michael McGreevy says March 18, 2021

The article was very clear thank you for writing it. I have heard irregularities and other symptoms and a low TSH. I’m taking beta blockers amiodarone and Eliquis.I’m not sure if these conditions are related to my thyroid but I’m seeing a doctor regarding this.

Kem says April 11, 2021

In 1985 I had just had my 1st child and my Gyn/Ob told I had Hashimotos, she couldn’t prove it as there was no test available at that time but she was 100% sure I had thyroid issues. Fast forward to late 2006, my hair was falling out, I had 3 kids, couldn’t get out of bed I was so fatigued, the brain fog was bad enough I thought it was early Dementia, I was always freezing and I was quiet a bit overweight. I had gone to my PCP and he said my temp was 94 degrees, said some people run lower than others. He tested TSH and Total T4, he said I was in range and put me on antidepressants. They made me feel even worse so I stopped taking them. I went back to PCP and was basically told it was all in my head, he’d write a referral to a Psychiatrist if I’d like. I fired him on the spot, I knew my body was sick and it wasn’t my fault he couldn’t figure out that my thyroid was being attacked as a foreign invader for years.

It wasn’t long afterwards in 2007 I went for my annual at my gynecologist and he noticed something wasn’t right so he ran all the tests you mentioned and properly diagnosed me. He also did a circadian cortisol saliva test and found my adrenals were really tanked, the cortisol blood test he ran didn’t show Addisons but my Gyn felt I was adrenal insufficient. He forwarded me over to a new PCP (an Internist) with the test results and diagnosis. She agreed on diagnosis and put me on Synthroid but that made me feel a lot worse. I was sleeping 12-18 hours a day & felt like I had Mono I was so fatigued. I had heard of Armour and Cytomel and asked about it but she was so afraid to try T3 or NDT lest I become Hyperthyroid. I asked her if we could do a trial but she just didn’t feel comfortable doing a trial to see if they would help. By that time I was desperate to find a medication that would fix the problem as I ended up getting a swollen neck with thyroid nodules that were quiet large and had to have fine needle aspiration. Thankfully all nodules were benign.

I went back to my Gyn in tears. He had the courage and knowledge of hormones to get me started on Armour thyroid. It was like my life had started over. When I got up to 3 grains of Armour I began getting old hypo symptoms again, my tsh was 0, Free T’s were low but antibodies were rising again. He ran an RT3 test and said it was a RT3 issue and dropped me to 1 gr of Armour and started me on 25 mcg of Cytomel. Almost immediately I immediately I started to feel better. As time went on my antibodies lowered little by little as we upped the Cytomel dose. At 75 mcg Cytomel and 1 gr. of Armour I had my life back. Antibodies were almost at 0 like my TSH, Free T3 was a bit over 1/2 way in range, Free T4 was right under range but I felt good enough to get out of bed, do the laundry, live life again. My temp averaged 98.6. and I wasn’t getting cold anymore. I have since gone through menopause in 2011 and he placed me on .1 mcg Vivelle Dot and 200 mg Prometrium. I also take 20 mg. of Hydrocortisone as a physiological dose of cortisol. I’ve had 2 DEXA’s, minimal bone loss at age 65 now. I do take vitamin D and Calcium in addition to my multivitamin. I have no heart issues though weight remains a issue.

Sadly my Gyn passed away and trying to find a new doctor to take over my thyroid health was a nightmare. 0 TSH, T3 and post menopause is like a cuss word in the medical community, everyone must fit into the same gold standard of care whether it makes you sick or not. 1 doctor put me back on Synthroid, she didn’t believe RT3 could be an issue, within 2 weeks I couldn’t get out of bed or function. I saw another doctor, he allowed me to have 2 grains of Armour. Sick again, antibodies skyrocketed, RT3 was elevated. By chance I heard about a Nurse Practitioner in town who took her time with patients and listened to them. I brought her all my paperwork, past test results and she actually read them, asked questions and shook her head as to why I’d had to be put through hell when I was feeling fine while my Gyn had found answers that worked for me. She immediately wrote my old 1 gr. of Armour and 75 mcg of Cytomel prescriptions, cautioned me to start slowly on the T3 and check back each month. I’m back to living life again and promised myself I’ll never allow another doctor to make me sick out of ignorance again. I’m glad you get it, sadly few do.

    Dr. Jeff Whelchel says April 11, 2021

    Wow. Thank you for your reply. I hope it will help someone and give them hope. We have to take back control of our own healthcare.

Theron Bailor says August 6, 2021

Dr. Whelchel,
I am on Armour Thyroid 240gr. My TSH was suppressed and undetectable in a hospital lab draw. 6 months ago my Dr, did labs and My T4 free was 1.11, Reverse T3 was 17.8, T3 Free was 3.8. feel fine, but 3 Drs. at a local hospital I was in stated I needed to fix my TSH. Thoughts?

    Dr. Jeff Whelchel says August 7, 2021

    Hello. As I said in the article, if you aren’t having symptoms of hyperthyroidism (jittery, palpitations, tremor) then I don’t think it is dangerous. Your free hormone levels are great (not high). In that instance, I don’t get as concerned with a suppressed TSH. I would suggest monitoring your bone density just in case. You could even consider dropping the armour dose slightly as long as your free T3 stays above 3.5. Of course, you need to see your thyroid doctor before doing anything.

Steven Gavazza says November 12, 2021

A very thorough summary that makes sense to a layman (me). I usually have suppresses tsh and low FT4 and mid to low FT3. My PCP hates this but my naturopath loves it. Currently my tsh is undetectable and my hormone levels are as high as they have ever been but “normal”. I feel ever so slightly edgy which leads me to believe the truth may lie in between my healthcare providers. I have often wondered whether a “normal” hormone level is normal for ME. A small dose reduction in my Armour would elevate my tsh slightly and reduce my FT3 slightly in the normal range and that might be just right for me. In other words rather than be afraid of suppressed tsh just use it as a guide to finding my best hormone levels. Does that make sense?

    Dr. Jeff Whelchel says December 22, 2021

    You make complete sense. How the patient feels is more important than any lab result. We unfortunately have forgotten that many times.

Araxie Bautista says January 2, 2022

My doctor is only going by my TSH which is suppressed but I have done my own labs and they fall in a good/optimal range. T4-1.0 T3-4.8 and RT3-10. My doctor is worried about the low TSH and wants me to lower my Armour from 120 to 90. I refuse. I will feel terrible. She will not do the other labs. I have asked for an ultrasound and she will not give me a referral. I do not have any of the hyer symptoms. I think its time to get another doctor. I am also on bio-identical hormones-Biest 2.25 estrogen/30 Progesterone. What do you think?

    Dr. Jeff Whelchel says February 11, 2022

    When a doctor will not work with you or listen to you, it is probably time to look for another. Your levels seems to be in a good range.

MB says April 4, 2022

How do you raise T3 (2.6 pg/ml) when all other hormones are in range?

    Dr. Jeff Whelchel says May 10, 2022

    I would need way more information than that to give you a proper answer. Diet, stress, other diseases, what thyroid medication you are taking, other lab results, etc.

Andrea Kittell says July 17, 2022

Excellent article. Thank you.

    Dr. Jeff Whelchel says July 25, 2022

    I’m glad you liked it. I hope it helped.

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